Opportunistic Infections: Prophylaxis

Case 4: Latent Tuberculosis Infection

You answered:

You should discontinue his antiretroviral therapy and start him on four-drug TB treatment.

This answer is incorrect. This patient has no evidence of active TB and, therefore, does not require four-drug therapy. He should be treated for latent TB infection with 9 months of isoniazid (INH) due to his significant exposure to his partner with active pulmonary TB. Discontinuing HAART is also not recommended in order to start INH. Although there are important drug-drug interactions between some TB medications and antiretroviral medications, INH is generally free of significant interactions.